National Provider Identifier [NPI]: |
1629027222 |
Last Name Of The Provider |
SOLBERG |
First Name Of The Provider |
RONALD |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
DO |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3260 PROVIDENCE DR |
Street Address 2 Of The Provider |
TOWER C, SUITE 537 |
City Of The Provider |
ANCHORAGE |
Zip Code Of The Provider |
995084661 |
State Code Of The Provider |
AK |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Psychiatry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
12 |
Number Of Services |
217 |
Number Of Medicare Beneficiaries |
79 |
Total Submitted Charge Amount |
73791 |
Total Medicare Allowed Amount |
30522.11 |
Total Medicare Payment Amount |
23473.75 |
Total Medicare Standardized Payment Amount |
18880.97 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
0 |
Number Of Drug Services |
0 |
Number Of Medicare Beneficiaries With Drug Services |
0 |
Total Drug Submitted ChargeAmount |
0 |
Total Drug Medicare AllowedAmount |
0 |
Total Drug Medicare PaymentAmount |
0 |
Total Drug Medicare Standardized Payment Amount |
0 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
12 |
Number Of Medical Services |
217 |
Number Of Medicare Beneficiaries With Medical Services |
79 |
Total Medical Submitted Charge Amount |
73791 |
Total Medical Medicare Allowed Amount |
30522.11 |
Total Medical Medicare Payment Amount |
23473.75 |
Total Medical Medicare Standardized Payment Amount |
18880.97 |
Average Age Of Beneficiaries |
58 |
Number Of Beneficiaries Age Less65 |
48 |
Number Of Beneficiaries Age 65 to 74 |
|
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
45 |
Number Of Male Beneficiaries |
34 |
Number Of Non Hispanic White Beneficiaries |
66 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
25 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
54 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
18 |
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
20 |
Percent Of With Chronic Kidney Disease |
42 |
Percent Of With Chronic Obstructive Pulmonary Disease |
23 |
Percent Of With Depression |
75 |
Percent Of With Diabetes |
43 |
Percent Of With Hyperlipidemia |
41 |
Percent Of With Hypertension |
65 |
Percent Of With Ischemic Heart Disease |
28 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
44 |
Percent Of With Schizophrenia Other PsychoticDisorders |
42 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.8773 |